Another day with the NHS; 18 May 12

Of course if you turn and the train is already there it’s a quick sprint to get on board before the doors close. I’ve done that several times, successfully. Not last Thursday.

I’ve been getting over a case of tendonitis of my left heel Achilles and it takes forever. Without thinking I ran. One or two strides in I got the most incredible pain in my calf. I hopped onto the train but I was in agony. I was reminded of those athletes on the TV which suddenly pull up holding their calves. The drive home was very nervy; I anticipated more pain every time I used the clutch. I feared the worst: maybe surgery or at best a plaster cast for a month or so.

Next morning I was at the GP for a 0950 appointment. I was seen at 1015 and the doctor seemed to know what she was talking about; at least she didn’t google my symptoms. She talked about a possible tear, wrote a letter and gave me a prescription and sent me off to Addenbrookes. Take a good book she said.

I arrived at A&E at Addenbrookes at 1115 to begin what the NHS calls the ‘patient journey’.

The start of the journey was an interview with a triage nurse, there seemed to be lots of them about, who wrote illegibly on a form, repeatedly asked me if I needed painkillers, told me the wait would be less than an hour and then sent me to reception.

Reception involved my confirming name and address and date of birth and, ominously, next of kin. I was then told to sit on a green chair and wait. Which I did. There were few others there but they all waited too. Just occasionally a nurse came out and called a name and one of our number went in for some form of consultation before coming out and waiting again. My wait finally ended at 1300 when a ‘nurse practitioner’ called Andrew repeated the examination I’d had at the GP. He seemed just as competent and was worried that I had in fact torn the tendon. He said that I should have an ultra scan which he’d try to fix for the afternoon. He asked me to come back at 1400 when he’d have some news.

1415 and it’s good news! The ultrascanners can see me so off I went and at 1445 was called in for my scan. I got the benefit of two lady ultrascanners who concluded that there was no tear (more good news) and sent me back to A&E.

I waited on the green chairs again. I noticed a lot more people waiting now including most of those from the morning.  But in 5 minutes Andrew met me for a final consultation, not in his cubicle this time but in the corridor next to the medicines cupboard. He confirmed what the ladies had said,  told me to get the drugs on the prescription and to take it easy for a few more weeks.

Interestingly, but not surprisingly, my first consultation with Andrew was within 2 hours of my arrival at A&E and my complete journey took just under 4 hours, both standards set by the nice Mr Lansley.

On reflection it wasn’t such a bad journey. But there did seem to be lots of NHS staff either standing talking, moving or entering data into computers. I’m not sure what the % of time NHS staff on average spend directly with patients but I would guess it’s pretty low. I remember when I worked for Dow Chemical that we reckoned that 10% of the employees were sales people and that these spent just 10% of their  time directly with customers. That meant only 1% of the company’s time was actually spent talking to customers. My guess is a similar calculation and result applies in the NHS.

The people are good though, despite Mr Lansley. In my experience cleaners, porters, nurses, admin staff and doctors are good, hard-working and committed to and proud of the NHS. Despite the worst that successive governments have thrown at them, and they’ve thrown some pretty lousy initiatives of which the latest are as bad as any, the people remain a credit. There are scare stories but looked at as a % of all the ‘patient journeys’ that take place they are of course individually terrible but not endemic.

For me? I ‘wasted’ the best part of a day but read a lot of the Guardian which I generally don’t have time for and finished a ‘hard’ Sudoku. The result of my various consultations was negative in that it did not recommend any new action but at least now the inaction (take it easy) is evidence based.